During the early stages of the next human pandemic influenza, there will be limited or no vaccine and antivirals will be in short supply. Non-pharmaceutical interventions (NPI) may be the only available strategy to reduce influenza virus A transmission and protect the public's health. Surprisingly, little is known about the effectiveness of NPI strategies or the feasibility of implementing the interventions on a large scale. During the global SARS outbreaks, universities presented special challenges for virus transmission containment. The primary objective of our study is to measure effectiveness of selected non-pharmaceutical interventions (respiratory etiquette, hand hygiene, and face masks) to prevent influenza-like illness (ILI) among students attending a large, urban university. We will conduct a randomized controlled trial to measure NPI effectiveness in preventing ILI among students at the University of California at Berkeley. At the beginning of the 2006-07 and 2007-08 influenza seasons, students will be recruited and randomized to either no intervention or an online NPI educational intervention. Both groups will be contacted weekly to collect information on student ILI symptoms and NPI adherence through a short, online survey. A total of 6,000 students will be enrolled in the study over a two-year period. This design allows for examination of several linked NPI questions, which together provide a comprehensive assessment of NPIs in this population. Specific aims include: 1) Measure effectiveness of a respiratory/hand hygiene intervention in reducing ILI among university students; 2) Test student adherence to different NPI recommendations, including respiratory/hand hygiene recommendations and use of masks; 3) Determine the proportion of ILI cases that are caused by influenza A/B virus; 4) Examine the effectiveness of NPIs in reducing secondary transmission of influenza in student households and close contacts. In the event of an influenza pandemic, university campuses across the nation will be required to implement and provide education on respiratory and hand hygiene and mask use strategies for their student populations. The experience and results from this study will provide new information on how effective these strategies are in preventing influenza-like illness among students, and the feasibility of implementing the interventions and education on a university-wide scale. [unreadable] [unreadable] [unreadable]